| NPI | 1043255177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RP1001X Internal Medicine, Pulmonary Disease (Licence: LA MD.13300R) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: TX M1695) |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: PA MD062425L) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: WV 29926) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2025-08-12 |